Long Term Effect of General Practitioner Education on Antibiotic Prescribing (PAAIR2)

April 19, 2010 updated by: Henri Mondor University Hospital

Long Term Effect of General Practitioner Education on Antibiotic Prescribing: a Large Scale Randomized Study

Respiratory tract infections are the most common indication for antibiotic prescribing in primary care. Several studies have shown a strong relationship between antibiotic use and bacterial resistance. The aim of this trial was to assess the long-term effect of a continuous education program on general practitioners antibiotic prescribing behaviour. 170 physicians were included in this study. Physicians randomized in the education group attended a two days seminar focused on evidence-based guidelines on antibiotic use in respiratory tract infections. The intervention was limited at physicians level and did not target the patients.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

170

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Créteil, France, 94000
        • Henri Mondor Hospital, department of general practice

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • General practitioners practicing in three departments of the Parisian area in France
  • General practitioners attending a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.

Exclusion Criteria:

  • None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: control
Other: No education on antibiotic prescription rules.
GPs assigned to control group received no specific recommendations on antibiotic prescription.
Experimental: Training to antibiotic prescription
Physicians randomized in the education group attended a two days seminar focussed on evidence-based guidelines on antibiotic use in respiratory tract infections.
Other: Experimental: Training to antibiotic prescription
GPs assigned to the intervention group attended a two days didactic educational meeting on evidence-based guidelines for diagnosis and treatment of acute respiratory tract infection.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in the percentage of prescriptions containing an antibiotic between control and intervention groups (seminar on the treatment of respiratory tract infections).
Time Frame: Effect of the intervention 4 to 6 months after the educational training.
All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the percentage of prescriptions containing an antibiotic (antibiotic prescription rates) was compared between control and intervention groups.
Effect of the intervention 4 to 6 months after the educational training.
Change in the cost of antibiotic prescription between control and intervention groups (seminar on the treatment of respiratory tract infections).
Time Frame: Effect of the intervention 4 to 6 months after the educational training.
All prescriptions written by all general practitioners enrolled in the study were extracted each year from the French National Health System database. All data were compared to 2004 (baseline). Education group GPs attended a two-day seminar presenting evidence-based guidelines on antibiotic prescription in respiratory tract infections. The change (compared to baseline) in the cost of antibiotic prescription was compared between control and intervention groups.
Effect of the intervention 4 to 6 months after the educational training.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Long term antibiotic prescription rates
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
Long term change in the percentage of antibiotic prescriptions between both groups
Effect of the intervention 28 to 30 months after the educational training.
Long term antibiotic cost.
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
Long term change in the cost of antibiotic prescriptions between both groups
Effect of the intervention 28 to 30 months after the educational training.
Symptomatic drug prescription rates
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
Prescription rates of symptomatic drug for respiratory infections between both groups
Effect of the intervention 28 to 30 months after the educational training.
Symptomatic drug cost.
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
Cost of symptomatic drug between both groups
Effect of the intervention 28 to 30 months after the educational training.
Effect of patient age.
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
Effect of patient age on antibiotic prescription between both groups
Effect of the intervention 28 to 30 months after the educational training.
Effect of a seminar on problem-solving strategy on prescriptions.
Time Frame: Effect of the intervention 28 to 30 months after the educational training.
A second randomization was performed among the intervention group. In one subgroup, GPs attended an additional seminar on problem-solving strategies. Antibiotic prescription rates were compared between controls, evidence-based and problem-solving subgroups. Antibiotic cost was also compared between the both subgroups
Effect of the intervention 28 to 30 months after the educational training.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Henri Mondor University Hospital

Investigators

  • Principal Investigator: Clause Attali, MD, Henri Mondor University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2004

Primary Completion (Actual)

April 1, 2009

Study Completion (Anticipated)

April 1, 2010

Study Registration Dates

First Submitted

March 4, 2010

First Submitted That Met QC Criteria

April 19, 2010

First Posted (Estimate)

April 20, 2010

Study Record Updates

Last Update Posted (Estimate)

April 20, 2010

Last Update Submitted That Met QC Criteria

April 19, 2010

Last Verified

February 1, 2010

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PAAIR2

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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